PENDEKATAN MODEL CARE ZONING PADA PASIEN GANGGUAN JIWA DENGAN RESIKO PERILAKU KEKERASAN DI RUANG PSYCHIATRIC INTENSIVE CARE UNIT (PICU)

THE CARE ZONING MODEL APPROACH FOR MENTAL DISORDER PATIENTS AT RISK OF VIOLENT BEHAVIOR IN THE PSYCHIATRIC INTENSIVE CARE UNIT (PICU)

Abstract

Introduction: Psychiatric Intensive Care Unit (PICU) provides specialized care for patients with acute mental illness who are at risk of violent behavior, self-harm, or severe psychiatric symptoms. The care zoning model was developed to facilitate risk assessment, planning, implementation, and evaluation of nursing care in PICU settings. Objective: To describe the application of the care zoning model in patients at risk of violent behavior in PICU based on a systematic literature review. Methods: This study is a systematic literature review using the PRISMA guideline. Literature sources were retrieved from CINHL, Cochrane, ScienceDirect, and EBSCOhost databases with the following keywords: psychiatric intensive care unit, care zoning model, violence, aggressive, emergency psychiatry. Inclusion criteria were articles published in the last 10 years, written in English or Indonesian, and accessible in full text. Results: The care zoning model classifies patient care needs into red (high), amber (moderate), green (low), and black zones (outside hospital/forensic cases). Interventions are delivered through three intensive phases: phase I (first 24 hours) focuses on life-saving and injury prevention; phase II (24–72 hours) focuses on continued observation and stabilization; phase III (72 hours–10 days) emphasizes patient self-care. The model identifies five key risk items: emotional condition, violence/aggression, suicide/self-harm, impulsivity, and treatment non-adherence. Conclusion: The care zoning model is suitable for PICU settings as it supports comprehensive risk assessment, structured nursing interventions tailored to patient needs, and improves documentation accuracy and interdisciplinary communication.